The effectiveness and safety of giving antidepressant medications to children is controversial, and the U.S. Food and Drug Administration warns that these medications may lead to greater risks of suicidal thoughts and actions, particularly in the early stages of treatment. However, the National Institute of Mental Health indicates that the best treatment for children and adolescents with depression is a combination of medication and therapy, and that despite the risks of antidepressants, their use is still recommended.
Prozac
Prozac (fluoxetine), a selective serotonin reuptake inhibitor, or SSRI, is the only antidepressant medication approved by the U.S. Food and Drug Administration to treat depression in children and adolescents. Other antidepressants such as Zoloft have been approved for use in children, but for the treatment of obsessive-compulsive disorder, not depression. As reported by Robert Weis in "Introduction to Child and Adolescent Psychology," several research studies on Prozac have found it to be effective in treating depression in children and adolescents. It has few side effects.
Other SSRIs
Weis notes that there is some research supporting the use of the SSRIs Zoloft (sertraline) and Celexa (citalopram) in children and adolescents, but with small treatment gains. Other SSRIs, including Paxil (paroxetine) and Lexapro (escitalopram), have not been found to be effective. The U.S. Food and Drug Administration recommended in 2003 that Paxil not be given to children with depression. Overall, Prozac has shown the most reliable improvements in symptoms.
Tricyclics
Weis reports that before SSRIs came on the market in the early 1990s, children with depression symptoms were treated with tricyclic antidepressants--Elavil (amitriptyline), Tofranil (imipramine) and Norpramin (desipramine)--which increase norepinephrine and serotonin levels in the brain. Weis reported findings that although these drugs have been found to work in adults, they have minimal effectiveness and significant side effects in children.
SNRIs
SNRIs, or serotonin and norepinephrine reuptake inhibitors, are the newest class of antidepressants, and are similar to SSRIs in treating depression, though they act on two neurotransmitters, serotonin and norepinephrine, rather than just one as with SSRIs. Although Effexor (venlafaxine) is not approved for use in children, it is sometimes prescribed for children with depression. Weis reports that, as of 2008, SNRIs' efficacy has not yet been proven.
References
- U.S. Food and Drug Administration: Questions and Answers on Antidepressant Use in Children, Adolescents, and Adults: May, 2007
- "Introduction to Abnormal Child and Adolescent Psychology"; Robert Weis; 2008
- U.S. Food and Drug Administration: Understanding Antidepressant Medications
- National Institute of Mental Health: Depression
- National Institute of Mental Health: Antidepressant Medications for Children and Adolescents
